Efficiency Estimation of Various Doses of Tranexamic Acid in Cardiopulmonary Bypass Surgery

Abstract

Objective . To determine the effectiveness of various doses of tranexamic acid (TA) in the cardiopulmonary bypass surgery (CPB). Methods . The study included 128 patients who underwent the heart surgery with CPB. Three groups were formed: group 1 (n=30) – a loading dose of TA – 10 mg/kg was administered intravenously with titration – 1 mg/kg/h during CPB; the 2 nd group (n=32) – a loading dose of TA was administered intravenously – 12.5 mg/kg with titration – 6.5 mg/kg/h during CPB and 1 mg/kg/h in the first 6 hours after surgery; 3 rd group (n=66) – the control one. Results . The blood loss volume during the period from the operation onset to 42 – 48 hours after it, in the 1 st , 2 nd and 3 rd group of patients was: 20.9 (18.1; 26.7) ml/kg, 19.3 (13.9; 22.5) ml/kg and 22.8 (18.4; 27.6) ml/ kg; statistically significant differences were only between the 2 nd and 3 rd group of patients. The total volume of the chest tube drainage in the first 42-48 hours after the operation was significantly less in the 1 st group (475.0 (350.0; 650.0) ml) and the 2 nd group (500.0 (350.0; 550.0) ml), compared with the 3 rd group (600.0 (500.0; 750.0) ml). The use of TA in the 2 nd group of patients, compared with the 3 rd group, led to the decrease in the frequency of blood transfusions in the first 42-48 hours after surgery. In the 1 st group of patients, statistically significant differences in the frequency of blood transfusions were not found. mg/kg, titration of 6.5 mg/kg/ h during CPB and 1 mg/kg/h in the first 6 hours after surgery (total dose of 2.5 (2.1; 3.0) g) is optimal in the cardiopulmonary bypass heart surgery.